APOE and Alzheimer disease: Additionally, we observed that SPARE-AD scores increased more among APOE ɛ4/ɛ4 carriers relative to ɛ4 heterozygous participants (estimate = 0.033, SE = 0.015, P = 0.028), who had greater increases than ɛ3/ɛ3 carriers (estimate = 0.017, SE = 0.006, P = 0.008).